Journal of Liver Cancer

Case Reports

Huge Hepatocellular Carcinoma Exhibiting a Complete Response after Stereotactic Body Radiation Therapy: Kyung In Shin, Byoung Kuk Jang, Jin Hee Kim, Jae Seok Hwang; J Liver Cancer. 2020;20(2):167-172. Published online September 30, 2020; DOI: https://doi.org/10.17998/jlc.20.2.167

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Abstract PDF: To date, there are limited data and little consensus on treatment strategies for huge hepatocellular carcinoma (HCC). Surgical resection provides significantly better survival than other modalities for single large HCC regardless of tumor stage. Recently, with technological advances in radiation therapy, stereotactic body radiation therapy (SBRT) is considered an alternative treatment option for HCC. Herein, we present a case of huge HCC that was successfully managed by SBRT. Transarterial embolization, previously performed in Russia, was incomplete. It was also not suitable for resection and transarterial chemoembolization. Although the rationale for radiotherapy in huge HCC was insufficient, SBRT was performed because no other treatment options were available. Additional radiofrequency ablation was performed for small HCC in a different segment, and radiological complete response (CR) was achieved. The CR was maintained over 4 years. Therefore, SBRT may be an alternative treatment option for large HCC that is not suitable for curative treatment.

Gallbladder Fistula Treated with N-Butyl-2-Cyanoacrylate after Radiofrequency Ablation in a Hepatocellular Carcinoma Patient: a Case Report: In Tae So, Byoung Kook Jang, Jae Seok Hwang, Young hwan Kim; J Liver Cancer. 2019;19(1):69-73. Published online March 31, 2019; DOI: https://doi.org/10.17998/jlc.19.1.69

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Abstract PDF: Radiofrequency ablation (RFA) is a minimally invasive local therapy for hepatocellular carcinoma (HCC). Even though RFA is considered to be a safe treatment modality, a variety of complications have been reported. Recently, we encountered a case of refractory fistula between a liver abscess and the gallbladder after RFA. A 64-year-old woman diagnosed with HCC associated with chronic hepatitis B was treated by RFA. After RFA, she experienced abdominal pain, and abdominal computed tomography (CT) revealed a liver abscess complicated by a previous treatment of HCC, she was treated with intravenous antibiotics and percutaneous abscess drainage. Follow-up abdominal CT revealed a fistula between the liver abscess and gallbladder, which was successfully treated with percutaneous transcatheter n-butyl-2-cyanoacrylate (NBCA) embolization. We herein report the rare case of a refractory fistula between a liver abscess and the gallbladder after RFA in a patient treated with NBCA embolization.

A Case of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Treated by Hepatic Artery Injection Chemotherapy and Radiotherapy: Sang Jin Kim, Byoung Kuk Jang, Jae Seok Hwang; J Liver Cancer. 2017;17(2):158-162. Published online September 30, 2017; DOI: https://doi.org/10.17998/jlc.17.2.158

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Abstract PDF

External beam radiotherapy, transarterial chemoembolization and sorafenib are currently standard treatments for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. However, hepatic arterial infusion chemotherapy has been applied to advanced stage HCC with a view to improving the therapeutic effect. We experienced a case of advanced HCC with clinical complete response after hepatic artery infusion chemotherapy and radiation therapy and report that.

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A Case of Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Treated by Hepatic Arterial Infusion Chemotherapy and Radiotherapy
Jin Yong Lee, Jeong-Ju Yoo, Seong Joon Chun, Sun Hyun Bae, Jae Myeong Lee, Sang Gyune Kim, Young Seok Kim
Journal of Liver Cancer.2020; 20(1): 78. CrossRef

A Case of Early Multiply Recurred Hepatocellular Carcinoma after Surgical Resection in Patient Who Unprecedented Chronic Liver Disease: Wang Yong Choi, Byoung Kuk Jang, Woo Jin Chung, Jae Seok Hwang; J Liver Cancer. 2015;15(2):112-117. Published online September 30, 2015; DOI: https://doi.org/10.17998/jlc.15.2.112

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Abstract PDF: Hepatocellular carcinoma (HCC) have relatively well known causative factors such as chronic hepatitis B, chronic hepatitis C, alcoholic liver disease, Non-alcoholic fatty liver disease (NAFLD), liver cirrhosis and so on. Recently, interesting reports that HCC in the absence of cirrhosis or other chronic liver disease and HCC associated with NAFLD and metabolic syndrome are increasing in USA. So far, there is no report about these issues in Korea. We present a 65 yearold obesity male who had no preceding chronic liver disease history. He was diagnosed as primary HCC and the mass was removed completely. However, HCC recurred shortly after operation. Multiple recurred HCC were treated with transcatheter arterial chemoembolization. (J Liver Cancer 2015;15:112-117)

Original Article

Characteristics and Survival of Korean Patients with Hepatocellular Carcinoma: A Nationwide Random Sample Study: Young-Suk Lim, Seung Hyung Kim, Seung Hyung Kim, Jae Seok Hwang, Kwang-Hyub Han; J Liver Cancer. 2014;14(2):97-107. Published online September 30, 2014; DOI: https://doi.org/10.17998/jlc.14.2.97

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Abstract PDF

Background/Aim
s: Given the high incidence and mortality rate of hepatocellular carcinoma (HCC), ensuring high quality of registry data is important for the improvement of health service. Registries by voluntary reporting often lack case completeness and may cause selection bias. A statutory Korean Central Cancer Registry (KCCR) has case completeness and provides accurate information on HCC incidence, but provides limited information about HCC characteristics.
Methods
The Korean Liver Cancer Study Group (KLCSG) and the KCCR jointly built a nationwide cohort of patients who were diagnosed with HCC between 2003 and 2005. Out of 31,521 new HCC cases that were registered at the KCCR between 2003 and 2005, 4,630
case
s (14.7% of total HCC cases) were randomly selected and abstracted from 32 hospitals nationwide, and followed up until December 2011. After excluding 110 patients who met the exclusion criteria, a total of 4,520 HCC patients were analyzed.
Results
Mean age at the diagnosis of HCC was 57.1±10.8 years, and males comprised 81.0%. Hepatitis B was the predominant etiology (72%), and hepatitis C comprised 12%. Stage at diagnosis was 10%, 43%, 28%, 11% and 8% for modified International Union Against Cancer (mUICC) stages I, II, III, IV-A and IV-B, respectively. Initial treatment modalities were transarterial therapy in 53%, surgical resection in 10%, local ablation in 7%, and liver transplantation in 1%. The median survival was 1.4 years, and the 1-, 3-, and 5-year survival rates were 56%, 35% and 27%, respectively. Age, gender, Child-Pugh class, etiology, tumor stage at diagnosis, and treatment modality were factors independently related to survival.
Conclusions
About half of HCC patients are diagnosed at advanced stages in Korea. Curativeintent treatments are rarely applied to patients. This data provides unbiased information about the characteristics and outcome of HCC patients in Korea. (J Liver Cancer 2014;14:97- 107)

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Hepatocellular Carcinoma in Korea between 2012 and 2014: an Analysis of Data from the Korean Nationwide Cancer Registry
Young Eun Chon, Han Ah Lee, Jun Sik Yoon, Jun Yong Park, Bo Hyun Kim, In Joon Lee, Suk Kyun Hong, Dong Hyeon Lee, Hyun-Joo Kong, Eunyang Kim, Young-Joo Won, Jeong-Hoon Lee
Journal of Liver Cancer.2020; 20(2): 135. CrossRef
Subclassification of Barcelona Clinic Liver Cancer B and C hepatocellular carcinoma: A cohort study of the multicenter registry database
Sangheun Lee, Beom Kyung Kim, Kijun Song, Jun Yong Park, Sang Hoon Ahn, Seung Up Kim, Kwang‐Hyub Han, Do Young Kim
Journal of Gastroenterology and Hepatology.2016; 31(4): 842. CrossRef

Case Reports

A Case of Hepatocellular Carcinoma Exhibited over Partial Response after Hepatic Arterial Infusion Chemotherapy: Chang Wook Park, Young Lan Kown, Yong Jin Kim, Yoon Jung Kim, Hye Jin Seo, Kyung In Lee, Eun Soo Kim, Byung Kook Jang, Woo Jin Jeong, Kyung Sik Park, Kwang Bum Jo, Jae Seok Hwang, Young Hwan Kim, Jung Hyuk Kwon; Journal of the Korean Liver Cancer Study Group. 2010;10(1):40-43. Published online June 30, 2010

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Abstract PDF: Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis. Especially potal vein invasion is a grave prognostic indicator in the setting of HCC. There is currently no effective method for treatment of HCC with portal vein invasion. A 61-year-old female patient was diagnosed a massive HCCs in both hepatic lobe with portal vein thrombosis, based on computed tomography (CT) and increased tumor marker, α-fetoprotein. She was treated with intrahepatic arterial CDDP (10 mg on 1~5 day), 5-FU (250mg on 1~5 day) and leukovorin (12mg on 1~5 day) infusion via percutaneously implantable port system (PIPS) every 3 weeks, totally seven times. The patient was still living 6 months after first hepatic arterial infusion chemotherapy (HAIC) and follow-up CT showed partial response with necrosis of HCCs. We report here a case of advanced HCC with portal vein thrombosis that was effectively treated with HAIC via PIPS.

A Case of Hepatocellular Carcinoma Presenting with Rib Metastasis: Kyung In Lee, Young Lan Kwon, Yoon Jung Kim, Hye Jin Seo, Yong Jin Kim, Chang Wook Park, Eun Soo Kim, Byoung Kuk Jang, Woo Jin Chung, Kyung Sik Park, Kwang Bum Cho, Jae Seok Hwang, Jung Hyeok Kwon; Journal of the Korean Liver Cancer Study Group. 2010;10(1):64-68. Published online June 30, 2010

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Abstract PDF: Bone metastasis is not uncommon and shows poor survival in patients with hepatocellular carcinoma (HCC). We describe a case of HCC presenting with rib metastasis in a 54-year-old man. In spite of radiotherapy for rib metastasis, pain was sustained and size of lesions were increased. So we performd CT-guided percutaneous ethanol injection therapy (PEIT). Whenever new metastatic bone lesions were detected, we have done PEIT. However, abdominal CT scan at 25th month after diagnosis shows residual viable tumors in pelvic bone and multiple metastatic nodules in both lung. He is alive by taking conservative management for 27 months after diagnosis.

A Case of Benign Hepatic Nodule Difficult to Differenciate from Hepatocellular Carcinoma: Byoung Kuk Jang, Woo Jin Chung, Kyung Sik Park, Kwang Bum Cho, Jae Seok Hwang, Sung Hoon Ahn, Young Hwan Kim, Jung Hyeok Kwon, Yu Na Kang; Journal of the Korean Liver Cancer Study Group. 2007;7(1):45-48. Published online June 30, 2007

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Abstract PDF: Improved imaging techniques have led to increasing detection of hepatic nodules incidentally. In many cases, a lesion that has been detected by imaging studies is not sufficiently characteristic, or there are other clinical concern, so that an imaging guided percutaneous needle biopsy is performed for definitive diagnosis. But sometimes, there are diagnostic difficulty due to limited diagnostic samples. We report a case of diagnosis to benign nodule, but not confirmed specific disease, by repeated CT guided fine needle biopsy.

A Case of Combined Hepatocellular and Cholangiocarcinoma: Woo Jin Chung, Sang Hun Jeon, Dong Choon Kim, Ju Yup Lee, Kyung In Lee, Hye Jin Seo, Byung Kuk Jang, Kyung Sik Park, Kwang Bum Cho, Jae Seok Hwang, Sung Hoon Ahn, Ku Jeong Kang, Young Hoon Kim, Jung Hyeok Kweon, Young Hwan Kim, Yu Na Kang; Journal of the Korean Liver Cancer Study Group. 2007;7(1):59-61. Published online June 30, 2007

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Abstract PDF: A 51 years-old man who had postnecrotic liver cirrhosis due to chronic hepatitis B had elevated serum alpha fetoprotein level. According to computed tomographic findings, about 2.4cm sized mass was noted at segment 7 and he underwent segmentectomy. After 9 months later, multicentric recurrence was detected at segment 5-6, So, he underwent transcatheter arterial chemoembolization (TACE) and percutaneous ethanol injection therapy. After 22 months later, marginal recurrence was noted again at segment 6. So, he underwent 2nd TACE and he was following up over 30 months until now.

Two Cases of Advanced Hepatocellular Carcinoma Showing Good Response to Hepatic Arterial Infusion Therapy: Byoung Kuk Jang, Woo Jin Chung, Kyung Sik Park, Kwang Byum Jo, Jae Seok Hwang, Sung Hoon Ahn, Young Hwan Kim, Jin Soo Choi, Jung Hyuk Kwun; Journal of the Korean Liver Cancer Study Group. 2006;6(1):60-64. Published online June 30, 2006

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Abstract PDF: Prognosis of advanced hepatocellular carcinoma (HCC) treated by conventional therapies has been considered to be poor. Hepatic arterial infusion therapy (HAIT) has been tried for advanced hepatocellular carcinoma with portal vein tumor thrombosis or ineffective response to other treatment. We report two cases of advanced HCC showing good respense to transarterial chemoembolization and CT guided percutaneous ethanol injection therapy.

Two Cases of Bone Metastasis of Hepatocellular Carcinoma without Intrahepatic Recurrence: Byoung Kuk Jang, Woo Jin Chung, Kyung Sik Park, Kwang Bum Cho, Jae Seok Hwang, Sung Hoon Ahn, Young Hwan Kim, Jin Soo Choi, Jung Hyeok Kwon; Journal of the Korean Liver Cancer Study Group. 2006;6(1):89-94. Published online June 30, 2006

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Abstract PDF: Extrahepatic metastases of hepatocellular carcinoma (HCC) are now increasing due to prolonged survival. Extrahepatic metastases of HCC frequently develop in patients with more advanced stage and sometimes occur without intrahepatic recurrence. We report two cases bone metastasis of HCC without intrahepatic recurrence after treatment.

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